Healthcare Provider Details

I. General information

NPI: 1932442449
Provider Name (Legal Business Name): LINDSAY MICHELLE NOVACEK RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY MICHELLE SMITH RN, BSN

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E GREEN DR
HIGH POINT NC
27260-6707
US

IV. Provider business mailing address

3811 COTSWOLD AVE APT. L
GREENSBORO NC
27410-9613
US

V. Phone/Fax

Practice location:
  • Phone: 336-641-6530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN167384
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN259788
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN2276108
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: